P-137. Contención de la resistencia a los antimicrobianos en entornos de recursos limitados: la experiencia de Argentina en la Red de Acción Global en Salud - Módulo de Resistencia a los Antimicrobianos
Abstract Background The Global Action in Healthcare Network, antimicrobial resistance module (GAIHN-AR) is a CDC-led global network that partners with PAHO and Ministries of Health (MOH) in Argentina and Chile. Its goals are to prevent, detect, and respond to healthcare-related AR threats; it is a part of the CDC Global AR Laboratory and Response Network. We describe the containment response experience in 2 Argentine public hospitals participating in GAIHN-AR. Methods GAIHN-AR containment guidance was adapted to the local context and targeted carbapenemase-producing Enterobacterales (CP-CRE) carrying novel (Tier 1) or known, but rare, carbapenemases (Tier 2: non-OXA-163 OXA-48 variants, VIM, multiple carbapenemases, and pan-drug-resistant [PDR]). Hospital laboratories implemented new diagnostics for carbapenemase identification and developed protocols to communicate alerts of potential Tier 1 or 2 CP-CRE to hospital infection prevention and control (IPC) teams, MOH, and the National Reference Lab (NRL). Hospitals received training and support from MOH GAIHN-AR staff to conduct containment and IPC activities. Containment activities continued while alert organisms were confirmed or discarded by the NRL. Results During Jan 2023 -- March 2024, 20 alerts were generated (all Tier 2); 19 were not confirmed (17 were OXA-163, 1 was PDR non-confirmation, 1 was mixed culture). The remaining confirmed alert (NDM+KPC) generated a successful containment response with 7/7 contacts screening negative. With each alert, gaps were identified, particularly in communication across stakeholders and hospital IPC activities. In response, enhanced monitoring was implemented for hand hygiene, contact precautions and environmental hygiene, and the MOH developed a new informatic system to facilitate stakeholder communication. Conclusion Combating AR threats requires support and integration of IPC programs and clinical laboratories to ensure rapid communication and action when target organisms are detected. Support from CDC and PAHO was critical for implementation and MOH involvement is key for successful responses to AR threats. Although vital learning experiences, steps to limit false alerts are key to prevent response fatigue moving forward. Disclosures All Authors: No reported disclosures
Authors
- Verónica Berdiñas
- Fernando Pasterán (ORCID: https://orcid.org/0000-0001-5840-5869)
- C. Carrétéro (ORCID: https://orcid.org/0000-0002-3060-9939)
- Alejandra Corso (ORCID: https://orcid.org/0000-0003-1183-6746)
- Laura Barcelona
- Cecilia Echave
- Rachel Mann Smith
- Irene Pagano
- Ángel M Colque
- F. Ponce (ORCID: https://orcid.org/0000-0002-3864-1642)
- Laura Alonso Alemany (ORCID: https://orcid.org/0000-0001-6283-6266)
- María Inés Staneloni (ORCID: https://orcid.org/0000-0001-8259-7215)
- Andrea F. Gonzalez
- Nora Fueyo
- Tomas Fueyo
- Paula Iantorno
Institutions
- Hospital Pedro de Elizalde (AR)
- Administración Nacional de Laboratorios e Institutos de Salud (AR)
- CDC Foundation (US)
Publication Details
- Journal
- Open Forum Infectious Diseases
- Published
- 2025-01-29
- DOI
- https://doi.org/10.1093/ofid/ofae631.342
- Primary Topic
- Antibiotic Use and Resistance
- Type
- article
- Field-Weighted Citation Impact
- 0.00